Document Detail


Desmopressin add-on therapy for refractory nocturia in men receiving alpha-blockers for lower urinary tract symptoms.
MedLine Citation:
PMID:  23357213     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Alpha-blockers improve lower urinary tract symptoms (LUTS) associated with benign prostatic obstruction (BPO). Nocturia-a storage symptom-is a common complaint in men, however, it does not fully respond to alpha-blocker therapy, likely due to its multifactorial pathophysiology. We evaluated the efficacy and safety of desmopressin as add-on therapy for refractory nocturia in men previously treated with an alpha-blocker for LUTS. MATERIALS AND METHODS: Eligible patients were men 50 years of age or older with LUTS and persistent nocturia despite alpha-blocker treatment for a minimum of 4 weeks. The optimum dose of oral desmopressin was determined during a 4-week dose-titration period, and this dose was maintained for 24 weeks. Flow volume charts, total IPSS, IPSS subscores, uroflowmetry and post-void residual urine volume were assessed. RESULTS AND CONCLUSIONS: A total of 216 patients were enrolled in the study. Of these patients, there were 158(76%) patients with nocturnal polyuria, 15(7.2%) with decreased nocturnal bladder capacity, and 35(16.8%) with nocturia due to both causes. The number of nocturnal voids significantly decreased from a baseline mean of 7.0 to 5.7 episodes for 3 days at the 24 week visit. The average IPSS total and IPSS subscore significantly decreased by 4 weeks and were maintained at 24 weeks. In patients aged less than 65 years, IPSS voiding subscores were significantly improved at 24 weeks compared to those 65 years or over. Desmopressin add-on therapy for refractory nocturia in men previously treated with an alpha-blocker for LUTS improved voiding symptoms as well as nocturia, storage symptoms.
Authors:
Woong Jin Bae; Jang Ho Bae; Sae Woong Kim; Byung Ha Chung; Jang Hwan Kim; Choung Soo Kim; Hyun Moo Lee; Kyung Seop Lee; Tag Keun Yoo; Sun Il Kim; Seok Soo Byun; Ji Youl Lee
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-25
Journal Detail:
Title:  The Journal of urology     Volume:  -     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
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